Rowe Fiona J
a Department of Health Services Research , University of Liverpool , Liverpool , UK.
Strabismus. 2017 Sep;25(3):112-119. doi: 10.1080/09273972.2017.1349812. Epub 2017 Jul 31.
This study sought to explore the practice of orthoptists internationally in care provision for poststroke visual impairment.
Survey questions were developed and piloted with clinicians, academics, and users. Questions addressed types of visual problems, how these were identified, treated, and followed up, care pathways in use, links with other professions, and referral options. The survey was approved by the institutional ethical committee. The survey was accessed via a web link that was circulated through the International Orthoptic Association member professional organisations to orthoptists.
Completed electronic surveys were obtained from 299 individuals. About one-third (35.5%) of orthoptists saw patients within 2 weeks of stroke onset and over half (55.5%) by 1 month post stroke. Stroke survivors were routinely assessed by 87%; over three-quarters in eye clinics. Screening tools were used by 11%. Validated tests were used for assessment of visual acuity (76.5%), visual field (68.2%), eye movement (80.9%), binocular vision (77.9%), and visual function (55.8%). Visual problems suspected by family or professionals were high (86.6%). Typical overall follow-up period of vision care was less than 3 months. Designated care pathways for stroke survivors with visual problems were used by 56.9% of orthoptists. Information on visual impairment was provided by 85.9% of orthoptists.
In international orthoptic practice, there is general agreement on assessment and management of visual impairment in stroke populations. More than half of orthoptists reported seeing stroke survivors within 1 month of the stroke onset, typically in eye clinics. There was a high use of validated tests of visual acuity, visual fields, ocular motility, and binocular vision. Similarly there was high use of established treatment options including prisms, occlusion, compensatory strategies, and oculomotor training, appropriately targeted at specific types of visual conditions/symptoms. This information can be used to inform choice of core outcome orthoptic measures in stroke practice.
本研究旨在探索国际上斜视矫正师在为中风后视力障碍患者提供护理方面的实践情况。
设计了调查问卷并在临床医生、学者和用户中进行了预试验。问题涉及视力问题的类型、如何识别、治疗和随访、使用的护理路径、与其他专业的联系以及转诊选择。该调查获得了机构伦理委员会的批准。通过国际斜视矫正协会成员专业组织向斜视矫正师分发的网络链接来进行调查。
共收到299人完成的电子调查问卷。约三分之一（35.5%）的斜视矫正师在中风发作后2周内接诊患者，超过一半（55.5%）在中风后1个月内接诊。87%的斜视矫正师会对中风幸存者进行常规评估；超过四分之三是在眼科诊所进行。11%的人使用了筛查工具。使用经过验证的测试来评估视力（76.5%）、视野（68.2%）、眼球运动（80.9%）、双眼视觉（77.9%）和视觉功能（55.8%）。家庭或专业人员怀疑存在视力问题的比例很高（86.6%）。视力护理的典型总体随访期不到3个月。56.9%的斜视矫正师使用了针对有视力问题的中风幸存者的指定护理路径。85.9%的斜视矫正师提供了有关视力障碍的信息。
在国际斜视矫正实践中，对于中风人群视力障碍的评估和管理已达成普遍共识。超过一半的斜视矫正师报告在中风发作后1个月内接诊中风幸存者，通常是在眼科诊所。视力、视野、眼球运动和双眼视觉的经过验证的测试使用频率很高。同样，既定的治疗方法使用频率也很高，包括棱镜、遮盖、代偿策略和眼球运动训练，这些方法适用于特定类型的视力状况/症状。这些信息可用于指导中风实践中斜视矫正核心结局指标的选择。
